ASH'S ADVICE

March 18th of this year marked the seventeen year anniversary of the automobile accident that left me paralyzed from the neck down. Seventeen years is quite a long time and I believe by now I have living with a spinal cord injury down to a science. Sure, I have my days of not knowing exactly how to live life as a quadriplegic, but overall I have been quite blessed with maintaining a healthy lifestyle in my condition. Sadly, many people with spinal cord injuries end up acquiring a few serious medical issues. Throughout the years I have observed the top three health issues most individuals with a spinal cord injury face to be bone loss, weight gain, and skin problems.

According to the Northwest Regional Spinal Cord Injury System, "about 80% of individuals with chronic spinal cord injury have either osteopenia or osteoporosis." A spinal cord injury can result in a 30% to 40% decrease in bone density, which can lead to a higher risk of bone fractures. Think about it, people with spinal cord injuries sit in wheelchairs all day while those living without paralysis walk around most of the day. Quadriplegics like myself not only spend their days sitting down, but rarely move any limb at all. Thankfully, this quadriplegic has not experienced a bone fracture. A daily regimen of range of motion of my joints, a relatively healthy diet, and many vitamin supplements has become my key to success. The National Spinal Cord Injury Association recommends to consume a healthy diet with a sufficient amount of vitamin D, either from the sun or from a supplement, avoid smoking, limit alcohol and caffeine consumption, stay mentally and physically active, and avoid situations that can lead to a fall and consequential bone fracture. Another thing I have learned over the years is that muscle spasms can also help maintain a healthy bone mass by causing the muscles to pull on the bones. Physical therapy is also a huge contributor to healthy bone mass. It is best to come up with a regimen like I have and stick to it.

Another medical issue commonly experienced by individuals with a spinal cord injury involves weight gain. I know what you're thinking, most physically able Americans struggle with weight gain. What makes individuals living with a spinal cord injury any different? The answer to that question is simple cause and effect. Individuals living with paralysis are forced to live sedentary lifestyles, which leads to muscle reduction. This reduction in muscle mass leads to decreased metabolic rates and increased fat storage. Even as a quadriplegic who spends twelve or more hours a day out of bed and keeps track of what she eats, I experience the constant up and down of weight fluctuation. Unfortunately, there have not been many studies conducted surrounding weight gain in individuals with a spinal cord injury. However, I personally believe following the common guidelines of a healthy diet and some form of daily physical therapy makes a huge difference when it comes to maintaining a healthy weight, spinal cord injury or not. Many diet programs and weight loss surgeries work well when struggling with weight gain even with people living with paralysis.

If you have a spinal cord injury and you are reading this I guarantee you know how large the risk factor of skin breakdown is for us. Pressure sores can occur when an individual stays in one position for an extended amount of time. Skin breakdown occurs when the skin cells are starved of blood flow. Unfortunately, someone living with paralysis will not immediately feel the pain of skin breakdown and does not know when to change position based on this sensation. If a tiny pressure sore is not tended to immediately it can develop into a large sore so deep that the bone becomes exposed. I cannot even begin to estimate how many people I know of with a spinal cord injury who has been hospitalized because a pressure sore got out of control. Many people are forced to amputate one of his or her limbs because of an infected pressure sore. Thankfully, my pressure sore track record has been pretty much spotless over the years because I follow the same advice the Rehabilitation Institute of Chicago gives to patients on how to maintain healthy skin care. According to the RIC Life Center, "Skin stays healthy with a balanced diet, good hygiene, regular skin checks and pressure relief." I would like to personally emphasize the guideline to check skin regularly and change positions, not only at night when in bed, but also during the day when sitting up in your wheelchair. I truly believe those two actions have been the key to my successful skin health over the years.

A major resource available to individuals experiencing the unique consequences of life after a spinal cord injury is The Miami Project and Buoniconti Fund to Cure Paralysis. By going to The Miami Project's Paralysis Support Section, you can find medical advice surrounding common medical issues like bone loss, weight gain, and skin problems those living with paralysis face.